I get a shot of tramadol from urgent care if my relpax (rescue med) doesn't help it or doesn't completely get rid of my migraine. My neuro has never prescribed it in pill form for me, nor have I ever asked him, too. I have told him about the frequency of them and how relpax sometimes doesn't work. I wouldn't ask for a specific medication in my opinion, especially a serious pain medication.
Yes, unfortunately sometimes you do have to be on the med go round until you find a combo that works for you, and even then, it may end up suddenly stopping.
As for me, I am on 400 mgs topomax, 12 mgs Zanaflex spread throughout the day, and 1,500 mgs of depakote ER spread throughout the day.
This is over the course of 4 years of tweaking though. Best of luck to you. Migraines are miserable things to deal with.

I forgot to add, if you have insurance, make sure that you bring the book showing the medications that are covered to the neurologist on your visit. That way the doctor knows which meds your insurance will cover.

I suffer from migraines/headaches that seem to never stop. I had a surgery last month that was really painful and the recovery was almost more painful than the actual surgery. The medication that the surgeon prescribed to me was Tramadol and the most marvelous thing happened. I had one week of absolutely no head pain at all. Nothing at all! It was marvelous!
I was stoned, could not drive, and just pretty much laid in my room all day. But, my head did not hurt! I did not even tell my doctor that it had this effect. I do not want her to get a bright idea to prescribe it to me. I might let the neurologist know, but this is not something I want to take.